HomeMy WebLinkAboutPV2021-255 - Permit Application (2)Print Foran Worksheet for Combo Building & Solar Permit Application
City of Newport Beach -Building Division
F_ Comm'I F-, Residential TTA
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB F111L
F-Building[Grading ,Drainage _ Elec FMech Plum c, yd c,t
7 Cu Yd Fill F
Project Address (Not mailing address) F_ Flood f_-, Fire F_ Liq Landslide F_N/A Floor Suite No
Description of Work Use Const Type F-1
17V 17- . at PV• # Stones F—# Units (if Res)
Valuation $
New/Add SFF7777 RemodelSFF77777 Garage/New/Add Material/Labor I
OWNER'S NAME LastI.-evirl First -K I L -----------
Owners Address Owner's E-mail Address
City State zip F Telephone[____------------
APPLICANT'S NAME Last 6 5First
Applicant's Address
City State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
------ - - ---- - - ----- --
city State
Applicant's E-mail Address
Zip Telephone[
First Lic. No.
Architect/Designer's E-mail Address
Zip Telephone
ENGINEER'S NAME Last First F77777 Lic. No.' - - '" -- L
Engineers Address
- "' - - - - - -- ------------ - -- ----- ------ - -
City [ State F_
Engineer's E-mail Address
------- - - -- - ------- - - - --------- - - ------------ -
ZIP Telephone 1
CONTRACTOR'S NAME/COMPANY 1, 1,9 Lic. No.Class
tul4t, 13, F(LIC
Contractor's Address Contractor's E-mail Address
1 .. .. .. . ... .. .. .....
city State Zip Telephone Fl9ti- to 7,,5v00
SETBACKS REAR SETBACKS FRONT PERMIT NO. a12, I - - z 6 �?
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $